- Stable, narrow complex supraventricular tachycardias.
- Consider for unstable narrow complex reentry tachycardias while preparing for cardioversion. However, adenosine is not adequate, and cardioversion must be used in cases of unstable rhythms.
- Adenosine may be used for regular monomorphic wide complex tachycardia that is thought to be due to a reentry supraventricular tachycardia. This is because the wide QRS complex may simply reflect unusual depolarization of the ventricles as a result of the accessory pathway.
- IV PUSH: 6 mg. given rapidly over 1 to 3 seconds, followed by a bolus of 20 ml of normal saline
- May give a second dose of 12 mg. if needed in 1-2 minutes.
- Drug or poisoning induced tachycardia
- Second and third degree heart block
- May cause deterioration in irregular, polymorphic wide-complex tachycardia or ventricular tachycardia
- Transient flushing, chest discomfort or pain, brief period of asystole, bradycardia, ventricular ectopy may occur.
- Larger doses may be needed in patients who are taking theophylline or caffeine.
- Smaller dose (3 mg) in patients with heart transplant, central venous access, or on dipyridamole or carbamazepine.
Register and Prepare for the ACLS Certification Exam
Register and Prepare for the ACLS Recertification Exam